Drug use among youth and adults in a population-based survey in South Africa

Karl Peltzer, Nancy Phaswana-Mafuya

Illicit drug use is a growing public health problem. The aim of the study was to assess the prevalence of drug use and the sociodemographic and health characteristics that influence it among young and adult South Africans. Data based on the South African national population-based survey in 2012 for 26 453 individuals (52.0% women and 48.0% men) aged 15 years and older were analysed. Past 3-month drug use was assessed with the 'Alcohol, Smoking and Substance use Involvement Screening Test (ASSIST)'. Bivariate and multivariable logistic regression was conducted to assess the association between sociodemographic factors, health variables and any past 3-month drug use. Overall, any past 3-month drug use was 4.4%, 7.9% among men and 1.3% among women. The proportion of past 3-month cannabis use was 4.0%, followed by sedatives or sleeping pills 0.4%, amphetamine-type stimulants 0.3%, cocaine 0.3%, opiates 0.3%, inhalants 0.2% and hallucinogens 0.1%. Among the nine South African provinces, any past 3-month drug use was the highest in the Western Cape (7.1%), followed by the Free State (6.3%) and Northern Cape (5.2%). In adjusted, multivariable, logistic regression analysis among both men and women, younger age, being mixed race and hazardous or harmful alcohol use were associated with any past 3-month drug use. In addition, having been a victim of violent crime and sexual risk behaviour among men and having psychological distress among women were associated with any past 3-month drug use. An increase of any past 3-month drug use from 3.7% in 2008 to 4.4% in 2012 was observed in South Africa. Prevention and intervention activities targeting drug use, in particular in identified risk groups, need to be strengthened in South Africa.